Individual ProviderStephen Peter GormicanEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205(858) 626-6150(626) 447-0296PECOS EnrollmentBased on the most recent information from CMS, provider Stephen Peter Gormican does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1679682504Provider TypeIndividualFull NameGormican, Stephen PeterTitleDr.CredentialM.D.GenderMaleSole ProprietorYesEnumeration Date8/30/2006Last Updated6/27/2008Contact InformationPractice LocationPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205Phone(858) 626-6150Fax(858) 626-7117Mailing LocationMailing AddressPO Box 661687, Arcadia, CA 91066-1687Phone(626) 447-0296Fax(626) 447-6057Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseG32038CaliforniaProvider IdentifiersIDDescriptionIssuerID00G320380DescriptionMedicaidIssuerUnlistedCalifornia